How it Works

Methylprednisolone is a corticosteroid with higher potency than prednisone used to treat inflammation or immune reactions across various organ systems, endocrine conditions, and neoplastic diseases.

Methylprednisolone is a corticosteroid that prevents the release of substances in the body that cause inflammation. Methylprednisolone works by mimicking the effect of cortisol, a hormone released by the adrenal glands (which are located on top of the kidneys) that controls metabolism and stress.

Methylprednisolone and other steroids are helpful in multiple myeloma because they can stop white blood cells from traveling to areas where cancerous myeloma cells are causing damage. This decreases the amount of swelling or inflammation in those areas and relieves associated pain and pressure. More importantly, in high doses, methylprednisolone can kill myeloma cells. When combined with other myeloma drugs, it can increase the response to the treatment.

How it’s Administered

It can be administered in different forms: 

• Pills: take pills with food or after meals
• IV infusion into a vein 
• Injection into a joint or skin lesion (non-myeloma related)

The amount of methylprednisolone you will receive depends on many factors, including your general health or other health problems and the reason you are receiving this drug.  Your doctor will determine your dosage and schedule.

Your dose needs may change if you have unusual stress, such as a severe illness, fever, or infection, or if you have surgery or a medical emergency. Tell your doctor about any such situation that affects you.

It should not suddenly be stopped if it has been used long-term. Reduce dosage gradually over several weeks or months to allow the adrenal glands to return to their normal secretion patterns. Too rapid a withdrawal of methylprednisolone may cause symptoms such as bone and muscle pain, fatigue, weight loss, nausea, and vomiting.

Who Should Take Methylprednisolone

• Multiple myeloma patients
• Oral and intramuscular are indicated for multiple severe disorders: endocrine, rheumatic, collagen, dermatologic, allergic, ophthalmic, respiratory, hematologic, neoplastic, edematous, gastrointestinal, nervous system, and other disorders
• Joint and soft tissue injections are indicated for short-term treatment of diseases that cause joint damage, keeping inflammation at bay
• Intralesional injections and other formulations (cream, ointment, fatty ointment, and lotion) are indicated for a large variety of dermatologic lesions

Who Shouldn’t Take Methylprednisolone

• Patients with active fungal infection
• Patients with alcohol problems 

The Most Common Side Effects of Taking Methylprednisolone Include:

• Fluid retention (swelling in your hands or ankles)
• Muscle weakness
• Increased appetite and weight gain
• Mood changes 
• Trouble sleeping (insomnia)
• Skin rash, bruising, or discoloration
• Acne
• Increased sweating 
• Headache 
• Dizziness
• Nausea 
• Vomiting
• Changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist)
• Increased blood sugar levels (People with Diabetes may need to be monitored closely and have possible adjustments to diabetes medications)

Commonly Used With 

• Chemotherapeutic drugs such as vincristine and doxorubicin
• Immunomodulators agents such as thalidomide, lenalidomide and pomalidomide
• Proteasome inhibitors such as bortezomib and carfilzomib
• Monoclonal antibodies such as daratumumab and elotuzumab

Currently Being Tested With Methylprednisolone

• Chemotherapeutic drugs such as vincristine, melphalan, and doxorubicin
• Immunomodulators agents such as thalidomide, lenalidomide and pomalidomide
• Proteasome inhibitors such as bortezomib and carfilzomib
• Monoclonal antibodies such as daratumumab and elotuzumab
• Selective inhibitor of nuclear export: Selinexor

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